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Ensign Services

Medicaid – MDS Compliance Partner

Ensign Services, Dallas, Texas, United States, 75215

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Medicaid – MDS Compliance Partner

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Ensign Services Get AI-powered advice on this job and more exclusive features. About the Opportunity

Ensign Services, Inc.’s (ESI) Compliance Department is seeking a License Vocational Nurse or Registered Nurse Compliance Partner. Must have with at least five years’ nursing and Minimum Data Set (MDS) experience in the Skilled Nursing/Long Term Care environment. Primary responsibilities will involve performing Medicare/Medicaid billing audits and conducting internal investigations under direction of associate and chief compliance officer, reviewing, and analyzing medical records and/or claims to detect possible compliance or quality issues.

About the Company

Ensign Services, Inc. is a national leader in the growing healthcare industry. We are a progressive company that provides service and support to over 350 long-term care facilities located across more than a dozen states, and we are continuing to grow. These operations are supported by ESI’s “Service Center,” a world-class service team that provides clinical, legal, human resources, accounting, compliance, information technology, construction, and other resources necessary to allow on-site leaders to focus squarely on day-to-day business. Our compliance philosophy is to work as closely with field facilities, agencies and resources as possible to develop solid relationships that allow us to enhance and foster compliance throughout the organization. We not only provide training, oversight and auditing functions, but we also serve as partners to our providers to assist them in building successful businesses in an ethical and compliant manner.

Duties

Creates and presents regular training on Medicare/Medicaid claim management, clinical compliance and general healthcare compliance topics Performs billing compliance audits Performs Medicare/Medicaid claim review portion of internal compliance audits Analyzes claims data and medical records to detect possible compliance or quality issues and works to assist operations to develop a corrective action plan to resolve the same Conducts internal investigations involving general compliance and clinical issues under the direction of a lead compliance partner or the chief compliance officer Provides advice and instruction on claim denial management and appeals Travel required 70% of the time within Texas and surrounding areas/states

Experience/Qualifications

Must be a Licensed Vocational Nurse or Registered Nurse A minimum of five years’ experience in a Skilled Nursing Facility/Long Term Care Extensive experience in Medicare/Medicaid MDS Understanding of the legal and regulatory framework governing the skilled nursing industry Ability to work with all levels of management on potentially complex compliance/regulatory issues Excellent communication skills.

Desired Skills

Superior interpersonal communication skills Strong writing skills required to write and edit policies and procedures, compliance reports, and other communications Works well independently in a home office environment on long term projects and as a member of an interdisciplinary team An engaging and informative teacher for regular training of facility personnel regarding Medicare requirements Possesses and conveys high degree of credibility and integrity A desire to constantly improve Medicare/Medicaid management systems and organizational compliance Understands and accepts the unpredictable nature and needs of the compliance function in a large organization Exhibits analytical skills and an understanding of operational processes

Additional Information

Salary: Commensurate with experience Number of Positions Available: 1 Position Type: Full Time, Employee Benefits: Medical/Dental/Vision coverage, company-provided life insurance, 401(k) with company match, and sick/vacation plans. Schedule: Typically business hours but may vary depending on workload and travel needs - 40 hrs/week Location: Based out of home office and regularly travels to assigned facilities; must reside near a major airport in the following area:

Texas Seniority level

Seniority level Mid-Senior level Employment type

Employment type Full-time Job function

Job function Business Development and Sales Industries Hospitals and Health Care Referrals increase your chances of interviewing at Ensign Services by 2x Sign in to set job alerts for “Managing Director” roles.

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